Keeping It Safe, Tutterow

Keeping It Safe: Financial Impact of Firefighter Injuries

Issue 4 and Volume 25.

By Robert Tutterow
Last year, I had the opportunity to participate in a workshop for a report titled, “The Economics of Firefighter Injuries in the United States.” The National Institute of Standards and Technology wrote the report, and it was issued in November 2019.
Robert Tutterow

The project was sponsored by the National Fire Protection Research Foundation. The report was based on data from the National Fire Protection Association, the United States Fire Administration, and the Bureau of Labor Statistics. In each of the reports, it was noted that there are many injuries not reflected in their numbers, especially in the volunteer sector.

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I’ll cut to the chase: The annual estimated cost of firefighter injuries is between $1.6 billion and $5.9 billion. This translates to an estimated cost per fire department that ranges from $50,000 to $200,000. In turn, this breaks down to $1,500 to $5,500 per firefighter. Please note that these figures reflect occupational illnesses and diseases. This immediately begs the question: Why such a large range? Also, do we budget for firefighter injuries?


There are many reasons for the wide range. Data collection is severely lacking, and data for many injuries cannot be captured in an annual report. For example, if a firefighter suffers a severe injury that requires multiple surgeries and extended rehab, the cost can easily be spread over multiple years.

Personally, I found this project to be most interesting as I processed every injury report for the Charlotte (NC) Fire Department for 24 years. In total, there were around 3,000 reported injuries during that time. This did not include occupational illness or disease. I often tried to get a grasp on the overall financial impact of the injuries. Having participated in this workshop, I didn’t feel too bad about not being able to get a solid quantifiable figure because there are so many indirect costs. Our city’s Risk Management division was able to identify the direct medical treatment costs from the medical community and the number of working days missed, but the other costs were most difficult to determine. These other costs include “lost productivity, and diminished quality of life.” And, the administrative costs of processing injury reports and managing staffing based on lost days are difficult to determine.

In my department, when a firefighter was injured on the job, he would be placed on “light” duty. And often, when a firefighter was injured off the job, he was afforded “light duty” work. This helped minimize the number of “lost days” as determined by the bureaucracy—i.e., if the firefighter was working “light duty,” then there were no “lost days.” However, he was not part of the minimum staffing required to provide service, and “hire backs” were needed. Speaking of “light duty,” it was often said that it accelerated the healing process as most firefighters had no interest in working an 8-5 “light duty” assignment and wanted to return to active duty as soon as possible. In fact, there is considerable time—i.e., costs—involved in just managing a light-duty program. Contrarily, there were some benefits to “light duty” as our Logistics division depended on “light duty” to meet service demands. There were always firefighters on “light duty.”


Admittedly, this topic is not “riveting.” However, it could become very beneficial in helping fire departments justify budgets. This is particularly crucial in justifying safety equipment, safety measures, and safety features in apparatus. I suspect all of us have identified a safety or health need but lack the quantifiable data to support the need. Again, in my case, there was major resistance to providing annual medical exams. Firefighters and chief officers were afraid a condition might be found that would prohibit the firefighter from remaining on the job. Better dead than work a different occupation? Try to explain that to a logical person. That is such a selfish position when a firefighter’s children, spouse, and others depend on him. And, the city took the ridiculous position that if medical examinations were given to firefighters, then they would need to be provided to all employees. I don’t know about all employees, but I know of firefighters alive today who probably would not be if not for their fire department’s mandated medical exams. The bottom line: It is much harder to deny a budget request for safety equipment or a health program if there is data indicating it saves money in the end.


As the fire service deals with more and more cancer illnesses and mental health issues, the need for good data on injuries, illnesses, and diseases continually increases. The report identifies the following data collection needs:

  1. Better tracking, especially among volunteers.
  2. Better understanding of mental health and post traumatic stress disorder and their impact on fire departments.
  3. Better understanding of the direct and indirect costs as well as injury litigation and backfill.

The report can be found, at no charge, by searching for “The Economics of Firefighter Injuries in the United States.” It is not an easy read, but just scanning it will provide insight into the need to fill the existing reporting gaps. Reporting is not a strong trait among firefighters, but it can literally be a major tool in “self-preservation.”

ROBERT TUTTEROW retired as safety coordinator for the Charlotte (NC) Fire Department and is a member of the Fire Apparatus & Emergency EquipmentEditorial Advisory Board. His 40-year career includes 10 as a volunteer. He has been very active in the National Fire Protection Association through service on the Fire Service Section Executive Board and technical committees involved with safety, apparatus, and personal protective equipment. He is a founding member and president of the Fire Industry Education Resource Organization (F.I.E.R.O.).